Characterization of Invasive Superficial Colonic Cancer Using High Resolution Endoscopy with Virtual Chromoendoscopy (BLI) with Or Without Magnification Before Endoscopic Resection

Aims Polyps characterization during colonoscopy has been developed with the use of high definition and electronic chromo-endoscopy. Detecting the presence of cancer before endoscopic resection is capital, in order to choose the most suitable management.This detection is difficult, with variable performances between western and japanese endoscopists(10 % of concordance vs 60 %). Not much studies have been done in Europe so far on this topic.The aims of this study were to determine the incidence of cancer according to the endoscopic description of the lesions, and to define which endoscopic classification is mostly associated with a neoplastic risk.

Methods We conducted a prospective, observational study, including patients who underwent endoscopic resections between 2018 and 2020 for colonic lesions > 20 mm. Colonoscopies were performed by a single expert endoscopist using FUJI brand high definition endoscopes with or without magnification. The size of the lesions, their location, SANO classification, Paris classification, the LST type,the histology predicted by the endoscopist and the definitive histology of the resection specimen were noted.

Results 142 (71 men,71 women) patients were included. The mean size of the colonic lesions was 40 mm.31.7 % of the lesions were located in the cecum, 27.5 % the right colon, 8.5 % the transverse colon, 14.1 % the sigmoid and 11.3 % the rectum.The diagnosis of adenoma was correctly made by the endoscopist in 94 % of cases. 15/18 SSAPs (83 %) were correctly diagnosed by the endoscopist.15.5 % patients presented lesions of cancer on the histology (10 cancers in situ, 12 T1). Among the 10 cancers in situ, 2 were correctly diagnosed by the endoscopist.Among the 12 invasive cancers, 8 had been correctly diagnosed.

Conclusions The endoscopic diagnosis of invasive cancers by an expert correct in approximately 67 % of cases. These results confirm the usefulness of the SANO classification.The use of zoom did not improve performance in diagnosing invasive cancers.

Citation: Lherault G, Hallit R, Barret M et al. eP183 CHARACTERIZATION OF INVASIVE SUPERFICIAL COLONIC CANCER USING HIGH RESOLUTION ENDOSCOPY WITH VIRTUAL CHROMOENDOSCOPY (BLI) WITH OR WITHOUT MAGNIFICATION BEFORE ENDOSCOPIC RESECTION. Endoscopy 2021; 53: S156.

Publication History

Article published online:
19 March 2021